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Wearable Defibrillator

According to Zoll, the WEARIT-II registry includes more than 2,000 patients prescribed the LifeVest wearable defibrillator. Failure to contact Zoll and immediately replace the device after Message Code 102 appears on the device screen may result in serious patient harm or death of the patient because the device may fail to deliver therapy appropriately when needed” according to an FDA press release.
While I think that single-chamber ICDs are often preferred—especially in primary-prevention settings without pacing indications—in this patient who was already on escalating Wearable Defibrillator doses of antiarrhythmic medication, it might prove prudent to have the ability to pace the atrium in case there is spontaneous or drug-induced bradycardia.



Six weeks after WCD therapy commenced, rates of depression and anxiety dropped to 7 and 25%, respectively 32 It is not clear if patients recovered their emotional equilibrium as a result of WCD therapy or as a matter of course as they got used to their new identities as cardiac patients.
41. Recommendation  WCDs should not be used when nonarrhythmic risk is expected to significantly exceed arrhythmic risk, particularly in patients who are not expected to survive >6 months (Class III; Level of Evidence C). 41 Piccini JP, Allen LA, Kudenchuk PJ, Page RL, Patel MR, Turakhia MP. Wearable Cardioverter-Defibrillator Therapy for the Prevention of Sudden Cardiac Death.

If the first set of defibrillation waveforms delivered across the first set of vectors fail to establish a regular heart rhythm in the patient, the defibrillator circuit has the capability to deliver a second set of defibrillation waveforms across the second set of vectors.
44. Recommendation  Use of WCDs is reasonable as a bridge to more definitive therapy such as cardiac transplantation (Class IIa; Level of Evidence C) 44 Piccini JP, Allen LA, Kudenchuk PJ, Page RL, Patel MR, Turakhia MP. Wearable Cardioverter-Defibrillator Therapy for the Prevention of Sudden Cardiac Death.

While many automated external defibrillators (which require a second person to operate them) have been cleared for use in children, LifeVest is the only one worn by the patient and monitors the heart continuously for abnormal, life-threatening heart rhythms ( arrhythmias ). LifeVest responds automatically if it senses the need to deliver a shock, restoring a life-sustaining heartbeat.
27. Clinical Experience With WCDs  Newly diagnosed cardiomyopathy, NYHA class IV heart failure, and those for transplantation  42% experienced recovery and did not develop an indication for permanent ICD  None of the patients had SCD or required WCD therapy  Event rates lower in patients with newly diagnosed cardiomyopathy (<1%)  Event rates are also lower in patients with recent revascularization  Although overall event rates are lower in patients with newly diagnosed cardiomyopathy or recent coronary revascularization, retrospective observational data suggest that the WCD may confer a survival benefit 27 Piccini JP, Allen LA, Kudenchuk PJ, Page RL, Patel MR, Turakhia MP. Wearable Cardioverter-Defibrillator Therapy for the Prevention of Sudden Cardiac Death.

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